This study aimed to assess the prevalence of clinically significant depressive symptoms; utilization of mental health services and associated socioeconomic and clinical factors in three main population groups of older adults in Israel. We used data collected by the Survey on Health, Ageing and Retirement in Europe (SHARE). Our study included data from 3,517 participants (54% female, mean age 64 years), identified as belonging to three population groups living in Israel: Israeli-born and early-immigrant Jews (those born in Israel or immigrated before 1989), Israeli Arabs, and more recent immigrants from the Former Soviet Union (FSU). We applied logistic regression to estimate the association of socioeconomic and clinical characteristics with clinically significant depressive symptoms (4 and more points on the EURO-D scale) and the utilization of mental health services in each population group. The prevalence of clinically significant depressive symptoms was highest amongst FSU immigrants (44%), followed by Israeli Arabs (32%), and the lowest amongst Israeli-born and early-immigrant Jews (30%). Greater levels of self-reported disability and a higher number of chronic diseases were associated with clinically significant depressive symptoms in all three population groups. Utilization of mental health services was the least common in Israeli Arabs (17%) and was related only to physical inactivity, followed by FSU immigrants (36%), where it was associated with female sex, disability, and chronic diseases. Mental health services were utilized the most by Israeli-born and early-immigrant Jews (41%), and was associated with disability, chronic diseases, and working status. Based on these findings, we conclude that taking into account ethnic disparities in the burden of depressive symptoms and the rate of mental health services utilization among older Israelis is essential to tailor better prevention and treatment strategies.
Female veterans who serve in combat roles encounter diverse and cumulative stressors, such as combat exposure and gender-based hostility, that heighten their risk for posttraumatic stress disorder (PTSD), depression, and anxiety symptoms. However, little is known about the protective role of psychological strengths in mitigating these outcomes. This study applied a network analytic framework to examine the interrelations among psychological strengths, contextual stressors, and psychological distress, among Israeli female combat veterans. A sample of 450 Israeli female combat veterans completed online self-report questionnaires in a cross-sectional design study. Results show a network with two distinct clusters representing psychological distress and psychological strengths, with dense within-cluster and weaker cross-cluster connections. Bridge analyses identified self-esteem and self-compassion as key psychological strengths negatively associated with PTSD and depression symptoms and positively connected with meaning, hope, and self-efficacy. Among psychological strengths, hope, self-esteem, and meaning-centered coping demonstrated the highest node centrality, highlighting their integrative role within the network of psychological strengths. Findings underscore that resilience among female combat veterans reflects the dynamic interplay of adaptive strengths, rather than the mere absence of symptoms. Self-esteem, self-compassion, and hope may be important correlates of lower distress and stronger psychological functioning among female combat veterans, warranting further longitudinal and intervention-based research.
A national cross-sectional survey of 267 Israeli patients with chronic lymphocytic leukemia (CLL) examined patient-hematologist communication, shared decision-making (SDM), and treatment priorities. Perceived adequacy of information was moderate at diagnosis (mean 2.9/5) and higher during treatment selection (mean 3.5/5). Physician-led decision-making predominated (58%), while SDM was reported by only 29.5% of patients; venetoclax-exposed patients were significantly more likely to participate in SDM (OR = 4.93, p = 0.008). Treatment priorities varied, with complete response (36.5%) and quality-of-life (29%) most frequently endorsed; BTKi-exposed patients disproportionately prioritized quality-of-life over response or survival (OR = 3.5, p = 0.027). Overall communication satisfaction and treatment adherence were high, yet 24% of patients lacked any contact channel with their hematologist outside clinic visits. Gender-related differences in communication comfort were also observed. These findings identify important gaps in SDM implementation and communication continuity in modern CLL management that warrant structured interventions.
This study examined societal attitudes and knowledge regarding autism within Israel's culturally and socioeconomically diverse population. A total of 2,377 respondents completed the Societal Attitudes Towards Autism (SATA) questionnaire, translated into Hebrew and Arabic. The survey examined the effect of socio-demographic variables, including gender, age, education, income, ethnicity, and familiarity with autism or knowledge about and attitudes towards autism. Overall, respondents demonstrated positive attitudes (M = 69.5%) and relatively high levels of knowledge (M = 64.6%) about autism. Most respondents reported positive (56%) or very positive (35%) attitudes towards autism, and 91% of the participants expressed openness and acceptance towards autistic individuals. A substantial proportion of the respondents reported a high (56%) or very high (24%) level of knowledge about autism, suggesting that 80% the Israeli public is relatively well-informed. Women, midlife (30s to 50s) adults, respondents with higher education and high income, and respondents who were acquainted with an autistic individual reported more positive attitudes and had significantly greater knowledge about autism. Levels of autism acceptance and knowledge varied across ethnic groups, with Jewish respondents reporting more positive attitudes and greater autism-related knowledge than Muslim, Druze, and Christian respondents. Hierarchical regression analyses revealed that the level of knowledge was the strongest and most consistent predictor of positive attitudes. The findings underscore the importance of educational, socioeconomic, and cultural influences on public perceptions of autism. Promoting autism acceptance in multicultural societies such as Israel requires knowledge-based and culturally responsive educational programs, alongside opportunities for meaningful social contact between autistic and non-autistic individuals.
Background/Objectives: The purpose of the present study was to assess the relationships between attention level and personality traits among 44 older adults aged from 65 to 75 in the Israeli population. The participants were 19 females and 25 males, with a mean age of 68.13 years, and 12.32 years average of formal education, who provided clinical history for screening. Methods: The participants completed the 44-item Big Five Inventory, the d2 Test of Attention, and the Mathematics Continuous Performance Test (MATH-CPT), a computerized test that measures participants' attention levels by recording their responses to visual stimuli. Results: The results showed significant correlations between attention and the domains of Conscientiousness and Neuroticism. Linear regression analysis, with the MATH-CPT measures as the dependent variable and the Big Five personality factors as independent variables, revealed a significant model explaining 41.60% of the variance in MATH-CPT performance. Linear regression analysis of the measures of the d2 test of attention as dependent variables and the Big Five factors as independent variables showed a significant model that explained 47.70% of the variance. No association was found between age and the domains of the Big Five personality traits. Conclusions: This study discusses the implications of the significant correlations between personality domains and measures of attention in older adults. The findings suggest that individuals who are organized, task-oriented, goal-focused, responsible, imaginative, creative, and interested in educational experiences may be better able to perform attention-related tasks in older age.
The atrocities committed by the Israeli government in Gaza have included the killing of nearly 2 000 health workers and tens of thousands of Palestinian civilians. Gaza's health workers deserve universal praise for their unwavering dedication to this population suffering under theIsraeli invader. The World Medical Association and the entire medical community have remained silent or have taken insufficientpositionsin support of these selfless individuals, and have.
Carbonic anhydrase VA (CA5A) deficiency (OMIM 615751) is an ultra-rare inborn error of metabolism, presenting in newborns, infants, and young children with a pentad of encephalopathy, hyperammonemia, lactic acidosis, ketonuria, and hypoglycemia. We present two cases: a case of a healthy Bedouin infant admitted with hyperammonemic encephalopathy that required urgent hemodialysis, and her younger sibling, who presented with a milder episode. Molecular analysis confirmed the diagnosis of CA5A deficiency due to a homozygous missense variant in the CA5A gene. Both patients had a favorable outcome with continued normal development. These were the first identified cases of CA5A deficiency in the Bedouin population, emphasizing the importance of a high index of suspicion, early genetic consultation and diagnosis, and prompt treatment at the earliest possible stage of a hyperammonemic crisis.
Accurate knowledge among healthcare and mental health professionals caring for sexual and gender minority (SGM) youth is central to affirmative, culturally competent practice, yet it is frequently conflated with attitudes or self-perceived competence. This conflation limits detection of concrete knowledge gaps that may undermine clinical practice. The present study developed and validated the Sexual and Gender Minority Knowledge Scale (SGM-K), an objective measure of professional knowledge relevant to affirmative youth care. The scale was validated among healthcare and mental health professionals in Israel (N = 318). Analyses established a parsimonious, psychometrically sound instrument and examined associations with theoretically related and unrelated constructs. Findings supported a coherent structure encompassing foundational knowledge of sexual and gender diversity, key concepts and terminology, and clinically relevant awareness of disparities, diagnostic considerations, and policy contexts. The scale demonstrated acceptable reliability. Knowledge was moderately associated with affirmative beliefs, behaviors, and attitudes; showed negligible relations with perceived societal tolerance; and differentiated professionals by training, personal contact, and clinical experience. The SGM-K offers a brief, objective, theory-driven tool for research, workforce development, and evaluation of affirmative care initiatives. Future research should examine cross-national validity and measurement invariance across cultural settings.
The ongoing Israel-Palestine conflict has significant consequences for children, youth and families from diverse communities in North America. In a time of widening social polarization, many children and youth are implicated in reiterations of the conflict at home, at school or in their neighborhoods. This divisive context has numerous indirect and direct clinical consequences requiring clinicians' awareness, attunement, and skillful response. Building on clinical experiences in Quebec (Canada), this paper questions the cultural safety of clinical interventions at three levels. First, the conflict can alter the therapeutic alliance in unspoken ways, requiring ongoing attention to cultural and contextual securitization. Second, because of its potentially traumatic impact, the conflict can influence symptom presentation in subtle or overt ways. Third, the internalization of the conflict can prompt forms of challenging acting-out, potentially eliciting stigmatizing clinical or social responses. Overall, preserving cultural safety in this context requires favouring a systemic assessment of the patient and their lived experiences, considering simultaneously the family, school and community context. Minimizing silence and avoidance by addressing the possible distress and divisions-or indeed outright divergences-within clinical and school teams may foster a respectful and safe enough environment, in spite of the differences in meaning within and across heterogeneous communities. The ongoing Israel-Palestine conflict has significant consequences for children, youth and families from diverse communities in North America. In a time of widening social polarization, children and youth are implicated in reiterations of the conflict at home, at school or in their neighborhoods. This divisive context has numerous indirect and direct clinical consequences requiring clinicians’ awareness, attunement, and skillful response. Building on clinical experiences in Quebec (Canada), this paper questions the cultural safety of clinical interventions at three levels. First, the conflict can alter the therapeutic alliance in unspoken ways, requiring ongoing attention to cultural and contextual securitization. Second, because of its potentially traumatic impact, the conflict can influence symptom presentation in subtle or overt ways. Third, the internalization of the conflict can prompt forms of challenging acting-out, potentially eliciting stigmatizing clinical or social responses. Overall, preserving cultural safety in this context requires favoring a systemic assessment of the patient and their lived experiences, considering the family, school and community context. Minimizing silence and avoidance by addressing the possible distress and divisions or outright divergences within clinical and school teams may foster a respectful and safe enough environment, in spite of the differences in meaning within and across heterogeneous communities.
The integrated threat theory (ITT) highlights the role of symbolic and realistic threats in predicting negative attitudes towards out-group members. However, little is known about how perceived threat may influence credibility judgement. Drawing from social identity theory and ITT, this study aims to expand current knowledge by examining a conceptual model. The model posits that perceived realistic and symbolic threat moderate the relationship between a suspect's ethnicity and credibility judgement. 404 Israeli-Jewish students participated, reading an alibi statement provided by either an Israeli-Jewish or an Israeli-Arab suspect, then answering questions about the credibility of the alibi statement and perceived threat. As hypothesised, the Israeli-Jewish suspect's alibi was perceived more credible than the Israeli-Arab's alibi. Also, symbolic threat moderates the relationship between a suspect's ethnicity and credibility judgement. These results underscore the importance of understanding majority-minority relations in criminology.
The concept of "x-ABCDE", with "X" representing exsanguinating hemorrhage, highlights the priority of immediate bleeding control in trauma care. Despite being a fundamental intervention, pressure dressing techniques lack standardization. Studies show high variability in achieved pressures, often below therapeutic targets or exceeding harmful levels, with no correlation between subjective estimates and objective measurements. To objectively assess current practices of pressure bandage application and identify influencing factors including material type, technique, and provider experience. This prospective, single-center, simulation-based observational study was conducted from August 2024 to January 2025 at a Level I Trauma Center. Emergency medical providers applied pressure dressings according to personal preference using available materials. Pressure distribution was measured via two calibrated capacitive pressure sensors (61 measurement fields). Analysis included correlation tests, group comparisons, and multiple regression. A total of 124 emergency medical providers (75% male; 36% paramedics, 44% emergency medical technicians, 13% trainees, 7% emergency physicians) completed pressure dressing applications, with 116 datasets included in final analysis. Mean maximum pressure was 169.35 ± 84.33 mmHg (range 50-412 mmHg) with application duration of 51.20 ± 18.14 s. Emergency physicians generated significantly higher pressures than non-physician groups (p < 0.001). The short-tug technique was the strongest predictor of maximum pressure (p < 0.001), followed by bandage material. Israeli bandages achieved highest pressures (205.40 ± 98.12 mmHg), followed by medium-stretch (171.68 ± 75.03 mmHg) and elastic fixation bandages (135.50 ± 58.63 mmHg). Excessive pressures > 250 mmHg occurred in 28% of Israeli bandage applications versus 11.1% for medium-stretch and 1.6% for elastic bandages. Pressure distribution showed volar focusing with highest values measured by the smaller sensor in the central area, best achieved through medium-stretch bandages. No correlation was found between subjective self-assessment and objective pressure measurements (p = 0.541). Pressure dressing application varies significantly by material, technique, and experience. While the short-tug technique and Israeli bandages achieved highest peak pressures, medium-stretch bandages demonstrated the most therapeutically consistent pressure distribution, with pronounced target pressure focusing and the lowest rate of excessive pressures within the present observational simulation setting. Lack of correlation between self-assessment and objective performance highlights the need for standardized training protocols and evidence-based technique guidelines.
Vasectomy is a simple, safe, and intended permanent surgical procedure for male contraception, yet its utilization in Israel remains low. This study aimed to characterize the demographic profile, motivations, decision-making process, satisfaction, and postoperative outcomes among Israeli men undergoing no-scalpel vasectomy. A 14-item questionnaire was administered to men undergoing no-scalpel vasectomy at Assuta Medical Centre, Haifa, assessing demographics, decision-making, consultation, concerns, symptoms, satisfaction, and regret. Of 55 invited patients, 35 (63.6%) completed the questionnaire. Most were married (65.7%) with two or three children; educational attainment was predominantly bachelor's degree (34.3%) or master's degree and above (28.6%); and 54.3% were employed in technology/high‑tech sectors. Primary motivations included avoidance of female contraceptive methods (80.0%), desire for permanent contraception (65.7%), procedural simplicity and safety (42.9%), and high efficacy (37.1%). Discussion initiation was by the male partner in 54.2% of cases, jointly in 22.9%, and by the female partner in 22.9%. Only 37.1% consulted a physician preoperatively, and few received a recommendation to proceed. Postoperatively, 60.0% reported mild symptoms (most commonly testicular discomfort); 48.6% resumed routine activities within three days and 40.0% resumed sexual activity within one to two weeks. Overall satisfaction was high-91.4% reported complete or general satisfaction; 100% reported no regret; and 91.4% would recommend vasectomy to others. Among Israeli men undergoing no-scalpel vasectomy, satisfaction was high (91.4%) with no regret. Partner involvement facilitates couple-centered counseling. However, the low rate of preoperative counseling and the limited provision of proactive referrals may reflect provider-level gaps when compared with Western primary care systems. Standardized, multidisciplinary, primary-care-anchored counseling on risks, irreversibility, and psychosocial factors may reduce anxiety and enhance informed decision-making.
Food insecurity has been linked to adverse health outcomes, but its relationship with ischemic stroke in older adults remains unclear. This study examined the association between food insecurity and ischemic stroke incidence among adults aged 65 years and older. This cohort study used data from the 2005-2006 National Health and Nutrition Survey of Israeli community-dwelling older adults, linked to the Israeli National Stroke Registry (2014-2022). Data were analyzed in 2025. Food insecurity was assessed using the 6-item United States Department of Agriculture household food security scale. First-recorded ischemic stroke events during follow-up, whether first-ever or recurrent, were included. Multivariable Fine and Gray proportional hazard models, accounting for death as a competing risk, estimated subdistribution hazard ratios (HRs) and 95% confidence intervals (CIs) for ischemic stroke by food security status: food insecure (low and very low food secure) vs. high food secure. The dataset included 1,337 participants (median age: 73 years, 57.4% women) who were alive on January 1, 2014, the start of the study follow-up. Over a mean follow-up period of 6.6±3.0 years (through the end of 2022), 82 ischemic stroke events were documented. After multivariable adjustment, food insecurity was associated with an increased risk of first-recorded ischemic stroke (HR=2.02; 95% CI: 1.12-3.65). When analyses were restricted to first-ever ischemic stroke events, the association was stronger (HR=2.65; 95% CI: 1.33-5.29). Food insecurity was associated with a higher risk of ischemic stroke among older adults. Addressing food insecurity may support stroke prevention in older populations.
Financial pressures on health systems have increased in recent years. Voluntary health insurance (VHI) could, in principle, fill in the gaps in public coverage and funding. However, there is little evidence on realized access to VHI-funded care - who uses it and for what services, especially in countries with high VHI ownership, such as Israel. Our study assesses gaps in VHI uptake and utilization across the Israeli population. Two consecutive cross-sectional data were collected through two national surveys among the adult population (aged 22+) conducted in 2012 and again in 2022, with respective response rates of 61% (N= 2,330) and 52% (N = 2,536). Bivariate analyses (ꭓ2) estimated the differences between population groups in the rates of VHI ownership and utilization of services at least once during the two years preceding the survey, while multivariable logistic regressions estimated the corresponding odds ratios. VHI ownership rates remained high (around 83%) in both surveys but varied across subgroups. Arabs, residents of peripheral areas, and those in the lowest income quintile had lower ownership rates and lower likelihood of owning it. Overall, VHI self-reported utilization stood at 66% in 2022, lower than 76% in 2012. Visits to specialists were the only service category with increased utilization (from 20% to 28%). In 2022, VHI owners with lower incomes, lower education, and those residing in peripheral areas were also less likely to report utilizing VHI. Yet, Arabs and ultra-Orthodox Jews were more likely to report utilizing VHI. Those reporting poor health were also more likely to report utilizing VHI. Our study examines VHI ownership trends and gaps in utilization of VHI-funded services in Israeli populations. The regressive nature of VHI premiums and disproportionately higher utilization by owners with higher socioeconomic status highlights the limitations of VHI as a sustainable and equitable financing policy tool for healthcare to policymakers. This unequal coverage demonstrates that VHI is not a full substitute for public funds, potentially indicating access barriers, while showing that fewer insured are benefiting from coverage. Its role should be clearly defined to ensure it complements public healthcare coverage.
Cryopreserved human heart valves and cardiovascular tissues (homografts) are essential for the surgical treatment of congenital and acquired valvular diseases, particularly in pediatric patients, where prosthetic options are limited. To address the clinical demand for high-quality grafts in Israel, Sheba Medical Center, the largest tertiary care hospital in Israel, established a Good Manufacturing Practice (GMP) compliant Cardiovascular Tissue Bank within the public health system. This report presents an overview of the bank's operation within the Israeli public health system over seven years, covering donor selection criteria, tissue processing procedures, microbiological safety measures, cryopreservation and distribution, as well as protocol optimization and validation. Between 2018 and early 2025, the tissue bank successfully transitioned from basic sterile techniques to full GMP-grade cleanroom operations, implementing validated protocols for decontamination, packaging, and cryopreservation. During this period, 142 donor hearts were processed, yielding 390 cardiovascular tissues, of which 338 were approved for clinical use and distributed to cardiac surgery centers across Israel. This paper provides a comprehensive operational overview of the Sheba Cardiovascular Tissue Bank from 2018 to 2025, describing protocol refinement, tissue procurement, processing, preservation, regulatory compliance, quality control, and distribution. By combining clinical collaboration, rigorous quality control, and GMP-based infrastructure, the bank plays a pivotal role in ensuring the availability of high-quality cryopreserved homografts for Israeli patients, especially pediatric cases with complex congenital heart disease, and provides a sustainable model for hospital-based cardiovascular tissue banking.
Specialty choice plays a central role in shaping physicians' careers and influences the distribution and sustainability of the healthcare workforce. In Israel, persistent shortages in specific specialties and geographic regions highlight the need to better understand the motivations guiding specialty preferences. Identifying latent motivational dimensions provides a broad perspective on the interplay between multidimensional factors shaping specialty choice. A cross-sectional survey was conducted among Israeli medical students in their final year and medical interns between July 2024 and January 2025. Participants completed an online questionnaire including demographic characteristics and motivational factors influencing specialty choice using 5-point Likert-scale items. Exploratory factor analysis based on polychoric correlations was performed to identify latent motivational dimensions. Factor associations with demographic characteristics and intended specialty were examined using proportional-odds ordinal logistic regression. A total of 527 trainees participated. Exploratory factor analysis identified three motivational dimensions: Interpersonal Factors, Career and Academic Development, and Lifestyle Aspects. All factors demonstrated acceptable internal consistency. No sex-based differences were observed for lifestyle or career and academic motivations, while women rated interpersonal considerations higher than men. Career and academic development motivations were stronger among trainees who studied abroad and among graduates compared with final-year students. Specialty-specific analyses showed that candidates intending surgical or obstetrics and gynecology specialties placed the greatest emphasis on career and academic development, while lifestyle considerations were more prominent among those aiming for pediatrics and psychiatry. Interpersonal motivations did not differ significantly across specialties. Specialty choice among Israeli medical trainees is shaped by distinct but interrelated motivational dimensions with important workforce implications. The shared importance of lifestyle considerations across sexes suggests that improvements in work-life balance may enhance recruitment across a wider range of specialties. Specialty-specific differences in career and academic motivations highlight the potential value of structured exposure during medical school rotations to research activity and academic career pathways, particularly in fields perceived as offering limited academic opportunities. Aligning training environments with trainee motivations may support recruitment to specialties in distress and contribute to long-term workforce sustainability.
Akabane virus (AKAV), a member of the Peribunyaviridae family, is an important arbovirus causing reproductive disorders and congenital abnormalities in ruminants. This study aimed to molecularly characterize AKAV isolates from different regions of Türkiye and assess their phylogenetic relationships using complete N gene sequences. A total of seven AKAV-positive samples, obtained from sheep fetuses and one Culicoides imicola specimen, were analyzed. Viral RNA was extracted, and the full-length N gene (702 nucleotides) was amplified and sequenced. Sequence analysis showed 519 conserved nucleotide sites and 183 conserved amino acid residues. Among genogroup Ib isolates, nucleotide similarity ranged from 95.72% to 100%, and amino acid similarity from 98.29% to 100%. A total of 47 nucleotide and 6 amino acid substitutions were identified; however, none were located within predicted epitope regions. Seven potential B-cell epitopes in the N protein were predicted and found to be conserved across all isolates. Phylogenetic analysis revealed that all Turkish isolates clustered within genogroup Ib and formed a distinct clade with Israeli isolates from 2018, while older Israeli and Japanese strains grouped separately within the same genogroup. Overall, AKAV strains circulating in Türkiye show high genetic similarity and conserved antigenic regions, contributing to a better understanding of the virus's molecular epidemiology.
Prosocial decision-making reflects how individuals weigh outcomes for themselves versus others and is shaped by cognitive and social-identity factors, and intergroup conflict. We investigated how intergroup dynamics, language use, and conflict context influence in-group favoritism and out-group discrimination in such decisions, among native Arabic and Hebrew speaking Israeli citizens, representing national minority and majority in Israel, before and during Israel-Hamas war. Participants (N = 338) completed a Social Value Orientation (SVO) task presented in different languages (L1, L2), that concerned in-group and out-group recipients. Across the full sample, participants were more prosocial toward in-group than out-group members, and intergroup bias intensified during the war. Notably, language conditions did not produce significant effects on intergroup bias. Among Arabic speakers, but not Hebrew speakers, national identity was correlated with intergroup bias only during the war. These findings highlight the way intergroup relations, such as minority-majority and active conflict, shape social decisions, and the dynamic and multifaceted nature of intergroup bias.
To assess artificial intelligence adoption patterns, trust levels, and perceived utility among physicians conducting disability assessments for a national insurance system, with a focus on the paradox between widespread use and limited trust in artificial intelligence for medico-legal decisions. Artificial intelligence is rapidly entering clinical workflows, yet its integration into insurance medicine-where physicians must translate complex clinical findings into legally defensible administrative decisions-remains unexplored. Physicians conducting disability assessments operate at the intersection of clinical judgment, administrative burden, and legal accountability, making them a critical population for evaluating artificial intelligence adoption and its epistemic limits. A cross-sectional survey was conducted in February 2026 among 428 physicians working in medical committees, appeals boards, and advisory roles at the Israeli National Insurance Institute (response rate 85.6%). The questionnaire assessed artificial intelligence usage frequency, trust in artificial intelligence-supported decisions (5-point scale), perceived risks, and preferred applications. Artificial intelligence adoption was widespread (76% regular or occasional use; 27% daily use), yet trust remained low (mean 2.7 of 5). Daily users showed higher trust than non-daily users (odds ratio 1.81; 95% confidence interval 1.14-2.88). Administrative burden was the dominant adoption driver. Preferred applications included medical record summarization (85%), inconsistency detection (45%), and protocol drafting (35%). Most use was informal, relying on personal tools. Senior physicians expressed relational concerns; less experienced physicians emphasized technical risks. Insurance medicine physicians distinguish between instrumental trust for administrative efficiency and epistemic trust for legally accountable judgment. Artificial intelligence integration should emphasize administrative augmentation while preserving human interpretative authority.
Combat exposure may lead to posttraumatic stress disorder (PTSD). Although written exposure therapy (WET) is an effective individual treatment for PTSD in soldiers, there is limited evidence supporting its effectiveness in group therapy. This study aims to expand our knowledge on implementing WET in group therapy, specifically among a cohort of 45 Israeli combatants with PTSD following recent participation in the war after October 7, 2023. The group-therapy treatment spanned a total of 12 sessions, incorporating the original WET protocol of five consecutive weekly sessions. The PTSD Checklist (PCL-5), Difficulties in Emotion Regulation Scale (DERS), Negative Mood Regulation Scale (NMR), and Group Cohesiveness Scale (GCS) were utilized before and after the total 12 sessions. Additionally, the Subjective Distress Units Scale (SUDS) assessed distress over the WET sessions. A repeated measures test evaluated the linear association of SUDS scores every week over the five WET sessions. Results revealed that distress symptoms decreased over the course of WET sessions, by means of SUDS score. The most notable reductions were observed between the fourth and fifth sessions. A significant difference in total PCL-5, NMR, and GCS was found before and after the 12 group sessions. All PCL-5 subscales showed significant decrease, while in DERS only the awareness subscale showed significant decrease. A linear trend was found between the end SUDS scores and the five WET sessions. The findings expand the growing literature on implementing WET in group therapy for combatants with PTSD.